ABSTRACT
Effi cacy and Effectiveness of Major Therapeutic Approaches ...................... 590 Cognitive-Behavioral Therapy .................................................................... 595
Coping With Depression (CWD-A) ......................................................... 595 Brief CBT .................................................................................................. 597 The Pittsburgh Cognitive Therapy Study .............................................. 597 TADS ........................................................................................................ 598
Pharmacotherapy ......................................................................................... 599 Suicidality in SSRI Treatment ................................................................ 600 Fluoxetine ................................................................................................ 601 Combination Treatments ........................................................................ 601
Interpersonal Psychotherapy ...................................................................... 602 Core Processes and Mechanisms in Treatment ............................................. 603
Cognitive-Behavioral Therapy .................................................................... 603 Cognitive Processes ................................................................................. 603 Behavioral Processes ............................................................................... 605 Interpersonal Processes .......................................................................... 605
Interpersonal Psychotherapy ...................................................................... 605 Cognitive Processes ................................................................................. 605 Behavioral Processes ............................................................................... 606 Interpersonal Processes .......................................................................... 606
Predictors and Moderators of Outcome .......................................................... 606 Severity of Depression ................................................................................. 606 Comorbidity ................................................................................................. 607 Family Environment and Parental Depression .......................................... 607
Conclusions and Future Directions ................................................................ 608 Notes ................................................................................................................. 610 References ........................................................................................................ 610
Thirty years ago, the existence of adolescent depression was still a subject of scientifi c debate. However, as the wide prevalence and substantial impact of depression in adolescence became well-established, efforts to develop effective interventions quickly followed. By the end of the 1980s, the fi rst randomized controlled trial (RCT) had been published (Reynolds & Coats, 1986); the 1990s brought 10 RCTs, and in the next decade, 18 clinical trials targeting adolescent depression have already appeared in the literature. The path of these treatments from conception to testing is a familiar one to observers of the youth therapy literature. Successful adult interventions were “childsized” for teens-dose adjusted, content simplifi ed, structure increased. As a result, the three best-supported interventions for youths with depression map directly onto the list of empirically supported adult depression treatmentscognitive-behavioral therapy (CBT), interpersonal psychotherapy (IPT), and the use of selective serotonin reuptake inhibitors (SSRI), particularly fl uoxetine. In contrast, research on “developmental” interventions, such as familybased or parenting-focused treatments has lagged far behind, as discussed by Garber, Webb, and Horowitz in this volume.
